Groundbreaking heart surgery saves man's life

February 27, 2003|By LISA HAYES

NEWS-REVIEW STAFF WRITER

On Feb. 16, Gary Thompson was on vacation from his job as an auto body repairman in Troy. He was in Northern Michigan, snowmobiling with his son, his son-in-law and his boss, and it was time for breakfast.

"It was Sunday morning and we were leaving to go to breakfast," Thompson said. "I pulled the rope on the snowmobile and something pulled in me."

He had a feeling the pain rushing through his body was a heart attack - he knew he had high blood pressure. But it was the day before his 50th birthday, and Thompson didn't want to miss the festivities downstate. He thought he should go to a hospital more near his home, but his son had a different plan in mind.

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"He refused," Thompson said. "He said we were getting it taken care of right then. And I was very lucky he said that."

Thompson went to Otsego Memorial Hospital, where doctors diagnosed a heart attack and sent him to Northern Michigan Hospital. Upon examination, doctors at NMH felt there was something much worse to his searing chest and back pain.

"He had torn his aorta, the main artery that comes out of the heart, in such a way that the layers separated and caused poor blood flow," said Dr. Brad Vazales, chief of cardiovascular and thoracic surgery at NMH. "He clipped off the right coronary artery, which goes to the right ventricle which is one of two major pumps to the heart. He had totally closed the right artery, and the poor flow to the right ventricle is what killed it."

Thompson had come to NMH for a standard angioplasty - "You open the artery, and things are better," Vazales said. But the surgeon had to completely replace the aorta. To do so, Vazales and his staff cooled Thompson's body, and shut off the heart-lung machine so there was no blood flow to the body for about 40 minutes. They replaced the torn artery and reconnected the other blood vessels that attached to his head, his arms, and the rest of his body.

"Since the tear had torn the right coronary artery off, there was no blood flow. His right heart didn't work at all, and there was no blood going into his lungs. We couldn't get him off of the heart-lung machine," Vazales said.

Only two options remained: Thompson could die on the table, or doctors could put in an ABIOMED BVS 5000, an artificial, external heart that would take over the function of the part of his heart that was dead.

"It's not available anywhere else in Northern Michigan," Vazales said. "We, of course, decided to put it in."

Only a few procedures with the system have ever been necessary at NMH, and following the surgery patients are shipped to the University of Michigan for a heart transplant. However, Thompson was in bad shape, and the University of Michigan could have rejected him.

"He was so critical, I was never really sure he'd be a candidate," Vazales said. "Also, I knew him better than anyone else would have there. I felt really comfortable keeping him here, not only because of the level of care we could provide, but because two of our traveling nurses had extensive training in care of this kind from other institutions."

Thompson was also so sick that transportation would be risky.

"He was so far gone, that we weren't even sure that his neurologic - his head status - would be normal," Vazales said.

The staff began caring for Thompson, and a surprising thing happened.

"He got better," Vazales said. "The right side of his heart slowly started to get better. To see if it was getting stronger, we tried to trangently lower the amount of support we were giving him with the artificial heart, to see how his own heart would respond. After about five days we noticed the right side of his heart was starting to recover a little at a time.

"The end of the story here is his right heart recovered enough that we were able to remove the artificial heart - that rarely happens, and it never happens in a community hospital."

Vazales said few community hospitals have the technology and care to support a recovery like Thompson's.

"He's the very first patient we've had where we've maintained and cared for in the most critical situation anyone could have been, removed the artificial heart, and maintained care afterwards," he said. "He doesn't need another facility and can go home likely the end of next week."

That's good news to Thompson, who has big plans.

"I have some physical things to overcome, but I don't think that's a problem," he said. "There's gotta be some reason I'm here, and now I've gotta find out what it is. I'm just so happy to be here, alive, and now I've got to find out why I am."

He's thankful he was taken to Northern Michigan Hospital.

"I had one shot left, and Dr. Vazales was the best shot I had, I think," he said. "The care was so good, that if there's anything else I need, I'm coming back here."

Thompson is focusing on regaining his strength to return to an active lifestyle. He and his wife have two kids and "a bunch of grandsons around, and one on the way" that he's looking forward to spending time with.

"I've got to be healthy for them," he said. "Maybe they're why I'm still here."